“Shutter Island” - Martin Scorsese (2010)

Stories of paranoia are especially gripping when shown on film – indeed that medium seems almost tailored for paranoiac narrative.  Why is that?  Certainly it’s partly due to the immersiveness of the film experience; but there is another aspect to it, as well.  As with all narrative, we reader/viewers are actively engaged in constructing the fabula (i.e. the  “world” of the story), but in the film case we are doing this on the fly and in real time.  This is just like the way we are always and continuously constructing the mini narratives around us in real time.  So if a filmmaker presents images and scenes that can have alternative fabula constructions, we are faced with the dilemma of deciding which of two alternative “worlds” is correct.  If we begin to suspect that the “true” world is different from the one everyone around is assuming, paranoia can take over.  Either we are crazy or everyone else is, which makes for an intense and involving viewing experience.  Movies have the unique power to evoke this feeling, and some memorable past efforts come to mind, including

• Bedlam (directed by Mark Robson and produced by Val Lewton, 1946)
• Invasion of the Body Snatchers (twice – Don Siegel, 1956; Philip Kaufman, 1978)
• Vertigo (Alfred Hitchcock, 1958)
• Shock Corridor (Sam Fuller, 1963)
• Rosemary’s Baby (Roman Polanski, 1968
• One Flew Over the Cuckoo’s Nest (Milos Forman, 1975)
• Mulholland Drive (David Lynch, 2001)

Shutter Island (2010) is another worthy offering in this line.  In fact given director Martin Scorsese’s mindfulness of movie history, it is not surprising that this film features more than a few references to some of those past works and directors.  There are two interesting aspects or angles to this film: it’s narrative structure and the psychiatric theme, which I will discuss in turn.

The Narrative Angle
The story, which has several layers of paranoia-inspiring schemes, begins in 1954 with federal US Marshals Teddy Daniels and Chuck Aule on a patrol boat headed for Ashecliffe Hospital, an insane asylum on an Alcatraz-like island in Boston Harbor.  The asylum houses the most incurable and dangerous lunatics in the country, and the two marshals have come to investigate the disappearance of a female inmate named Rachel Solando who has somehow vanished from the supposedly inescapable confinement.     

Narrative 1
Anyway, early on in the film, we’re following along on narrative level number one: the two marshals are trying to find out what happened to Rachel Solando, who is said to have murdered her three young children but is now living in a dream world and believing that her children are still alive.  Daniels and Aule are given free rein to explore the asylum by doctors Cawley (Ben Kingsley, in an eerily effective performance) and Sheehan (Max von Sydow), but they are warned not to go Ward C, where the most dangerous inmates are housed.  So the narrative goal to be achieved is to find the potentially dangerous antagonist, Rachel Solando, and see what has happened to her.

From the very outset there is a foreboding air of unreality about everything.  On the boat, Daniels and Aule are shown in unnatural studio back-projection and artificial lighting – a cinematic  technique that characterized Hollywood films of the 1950s, but which is conspicuously weird for a modern film.  In addition, the cinematography includes awkward axis-crossing reverse shots and rapid camera pans that contribute further to a contrived sense of unreality. The pounding offscreen music and mannered greeting that the two marshals receive on their arrival to the island only add to an odd sense of oppressive claustrophobia even in the outdoor surroundings of the pier.  Later, when the two marshals are interviewing the hospital’s staff about Solando’s disappearance, there is a bizarre sense of artificiality in the way everyone acts, as if everything is being staged for them.

Narrative 2
Soon there are additional narrative threads.  Daniels is haunted by memories of his deceased wife, who died two years earlier in a fire, and of his experiences in World War II, when he participated in the liberation of the Dachau concentration camp and the ensuring massacre of German soldiers.  He has nightmares of the Dachau horrors and daydreams of his wife talking to him and giving him obscure messages about his current mission.  So it is clear that Daniels is not exactly mentally stable, himself.  A little bit later Daniels confides to his partner Aule (whom he had only just met on the boat coming to the island) that his wife was killed in a fire set by a pyromaniac named Andrew Laeddis, whom he believes is an inmate at Ashecliffe, possibly held in the off-limits asylum Ward C.  Daniels wants to find and kill Laeddis.  The Daniels backstory narrative thread is obscure but obviously significant.  A new, presumably more significant narrative task has now been presented: to find the antagonist Andrew Laeddis.

Narrative 3
Eventually Daniels confides to Aule that his real reason for investigating the island is a personal mission to uncover secret medical experimentation allegedly being performed on the mental patients there.  He says these violations of human rights have allegedly been authorized by HUAC (the US House of Representative Committee on Un-American Activities), and they are being conducted in Ward C or at an isolated lighthouse just offshore. So now there is another narrative thread concerning the unsavory and inhumane medical experiments being conducted by a sinister and clandestine government agency.  This presents another narrative goal: to uncover and deal with a new set of antagonists, the evil psychiatrist miscreants.

Narrative 4
Finally, there is still another and culminating narrative explanation presented – that everything shown so far has been a sham and that Teddy Daniels is really the one who is insane. According to this narrative scheme, the preceding two hours of film have been depicting an elaborate playacting contrivance conducted as a vast psychiatric experiment in order to cure Teddy Daniels, whose real name turns out to be Andrew Laeddis, a man who killed his own wife.  In this narrative, the psychiatrists are the good guys, and the narrative goal has been to cure the mental illness suffered by Daniels/Laeddis.

If you watch Shutter Island a second time, you will see a number of visual cues along the way that point to the authenticity of this last narrative.  This may be disappointing for some viewers, because a good many people want to see psychiatrists cast in their usual roles as insidious and hypocritical villains.  They can’t really be the good guys this time, can they?  I like MaryAnn Johanson’s (the Flick Filosopher)  response to all this: “If what I think is happening here, is happening here, it better not be.” So some people have looked for even more devious explanations as to what has happened in the film.

Throughout the course of Shutter Island, the viewer is given the plot (i.e. the syuzhet) and seeks to construct the causal world surrounding that plot (i.e. the fabula).  But here it can be frustrating.  Likening narrative structure to travel, Kai Mikkonen sees this as constructing the map (fabula) from the itinerary (syuzhet) [1].  But Mikkonen also stresses that as we experience the events (for example, as we pass along through a journey), the “map” is open-ended.  There are all sorts of roads not taken that could have been.  We are constructing the itinerary as we go.  Thus the on-the-fly map/itinerary construction may be rather different from that final map/itinerary that we settle on in the end.  This distinction between the on-the-fly narratives and the final narrative is what lies at the heart of Shutter Island.

The Psychiatry Angle
Since the treatment of mental illness is a key aspect of Shutter Island, there are interesting issues associated with psychiatry under display.  Psychiatric treatment of mental illness has gone through roughly five phases over the last century:

1. Confinement (before the 1930s). Procedure: lock up mentally ill people in asylums to keep them out of harm’s way, but more or less neglect them.
2. Surgery and invasive procedures (1930s - 1950s). Procedure: subject mental patients to invasive and essentially trial-and-error surgery, such as electroconvulsive shock therapy and lobotomies.
3. Psychotherapy (1950s - ). Psychotherapy and Psychoanalysis.  Procedure: the therapist hypothesizes the existence of flawed mental structures in the mind of the patient and attempts to achieve a cure by making the patient aware of these flaws.
4. Psycho-chemicals (1960s - ). This development has involved a push towards achieving the status of a cause-and-effect “natural science”.  Based on the idea that the brain is simply a chemical structure that can be "repaired" by subjecting it to chemical treatment via drug ingestion, new pharmaceuticals were developed that were believed to cure mental illnesses. This reductionist approach has gone further in recent years to the point of assuming that psychiatric illnesses can be traced to individual genes, the detection of which via scanning can be used to see if patients are likely to suffer various disorders [2,3].
5. Social psychiatry (2000 - ).  More recently psychiatrists, seeing the frustrating failures associated with the preceding movements, have attempted to incorporate into their treatment the consideration of sociological influences on mental conditions [4].

Shutter Island puts us at the juncture of phases 2, 3, and 4.  Convulsive electroshock therapy was on the decline at the time of the story (1954).  Nevertheless, there is an indication throughout the film that Daniels/Laeddis had earlier been subjected to electroconvulsive shock therapy, although this is never explained in the film.  He is shown to have a bandage over his left forehead, corresponding to where the electrodes were likely to have been placed for this therapy [5].  Later on, after this bandage has been washed off in the shower, we can see a telltale scar on his forehead in the same spot.  Lobotomies were still being performed in those days, and that is the specter that haunts Daniels/Laeddis towards the end of the film.  But psychiatry was starting to take over and replace invasive surgery in the 1950s, while psycho-chemicals were just on the horizon – 1954 was the year that thorazine (chlorpromazine) was introduced.  Thus in Shutter Island the psychiatrists are, surprisingly, the heroes.  However, in the final scene of the film, there is a curious revelation.  It was always the psychiatrists’s belief that a patient would be cured by simply generating the self-recognition on the part of the patient of his or her own obsessions and fantasies.  This self-recognition would generate a miraculous cure, all by itself.  At the end of Shutter Island, however, the self-realization of Daniels/Laeddis lead to his recognition of his own monstrosity, and hence not to salvation but to self-destruction.

But the public at large was right to be suspicious of professional psychiatry’s pretensions to cure mental illness.  Psychiatry professor Thomas Szasz, in his book The Myth of Mental Illness (1961) [6], exposed the severe limitations of psychiatry, which went down the path of taking an innocent metaphor (that a person could be mentally “ill”) and attempting to attribute scientific exactitude to that term and at the same time asserting the scientific authority of its treatments.  Regrettably, however, psychiatry has never been more than a pseudoscience and has failed to come to any understanding of the etiology behind mental illness [7,8,9,10,11].

So it is a disappointment and a flaw of Shutter Island for Scorsese to celebrate psychiatry.  It is a flaw, too, that at the conclusion of the film, the viewer is compelled to reconstruct the entire narrative based on revelations made only near the conclusion. There is too much that is revealed at the end of the film, and this is a weakness of Shutter Island. Admittedly, there had been many clues that things were not quite right all the way along – the initial hypothesized narratives just didn’t add up and there was a clear suspicion that something was wrong. But, anyway, I guess that is what paranoia is all about.

★★★
       
Notes:

1. Mikkonen, Kai, “The ‘Narrative is Travel’ Metaphor: Between Spatial Sequence and Open Consequence” (2007), NARRATIVE, vol. 15, no. 3 (October 2007): 286-305.
2. Poole, Stephen, “Your Brain on Pseudoscience: the Rise of Popular Neurobollocks” (2012), New Statesman, 6 September 2012.
3. Tallis, Raymond, Aping Mankind: Neuromania, Darwinitis and the Mirsrepresentation of Humanity (2012), Acumen, Durham, UK.
4. Lurhmann, Tanya Marie “Beyond the Brain”, The Wilson Quarterly, Summer 2012.
5. See, for example:
• "Electroconvulsive Therapy: Experience of Patients", (2011), Electroconvulsive Therapy, 11 August 2011, http://electroconvulsivetherapy.net/.
• "Brain Stimulation Therapies", (n.d.), National Institute of Mental Health, Bethesda, MD, USA.
6. Szasz, Thomas, The Myth of Mental Illness (1961), Harper and Row, NY.
7. Rosenhan, David L., “On Being Sane in Insane Places”, Science,  19 January 1973: Vol. 179 no. 4070 pp. 250-258, DOI: 10.1126.
8. Scull, Andrew, “Psychiatry’s Legitimacy Crisis” (2012), Los Angeles Review of Books, August 8, 2012.
9. Greenberg, Gary, "The Future of an Illusion", Book Forum, February 2015.
10. "Psychoanalytic theory is the most stupendous intellectual confidence trick of the twentieth century and a terminal product as well—something akin to a dinosaur or zeppelin in the history of ideas, a vast structure of radically unsound design and with no posterity." – Sir Peter B. Medawar (Nobel Prize winner in Physiology or Medicine, 1960), The New York Review of Books (23 Jan 1975). 
11. More recently, psychotherapists have sought to counter the public's loss of confidence in their objective, technical proficiency by marketing more personal and specialized bite-sized services in the form of "life coaching".  See, for example, "What Brand Is Your Therapist?", by Lori Gottlieb, New York Times, 23 November 2012.